Individual
MELINDA L JORGENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3417 MERLIN DR, STE 102, IDAHO FALLS, ID 83404-7430
(208) 552-0850
(208) 529-5011
Mailing address
PO BOX 4285, POCATELLO, ID 83205-4285
(208) 236-1600
(208) 236-6695
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
12/03/2008
Last updated
12/15/2010
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